23 July 2012

Bari-Suits dehumanise fat people

When I first started encountering fat activism in the US in the early 90s, accessible medical equipment was a big issue. People couldn't get hospital gowns or blood pressure cuffs that fitted. When you're unwell or disabled and needing assistance, being treated with dignity is an important part of how people should care for you. When you're fat, you can't count on this kind of care because medical fatphobia is so endemic.

The emergence and popularity of surgical weight loss technologies, and casualties from other forms of weight loss, also added to a population of fat people who needed accessible medical care around the time that activists were demanding accessible equipment. Medical supply companies soon realised that they were looking at a profitable niche market. Benmor Medical is one such company, it was established in 1996 and now sells a line of products such as larger-sized wheelchairs, wide walking-frames, big bedpans, and gadgets that help move you around safely and gently if you are fat and otherwise immobile, and which guard the safety of the people moving you too.

What makes me queasy about Benmor Medical is that its products are not the result of critical community consultation with fat people encountering medical systems. Instead it sells products that reflect the interests of medical discourse, and within this model fat people can only exist as 'patients', that is, bottom-dwellers in the hegemony of health professionals. So as well as marketing mobility aids, it also sells a range of scales because weighing fat people is extremely important in this particular framework. This kind of marketing reproduces fat people as little more than medicalised meat. Added to this, I noticed on their news page that they were proud to have had their products placed in an exploitative TV obeso-shockumentary. Benmor Medical's language is of care and concern, but fat people have an ambiguous and unsettling place in the company's values, our voices and images are strangely absent, far less important than the tantalising equipment.

I found out about Benmor Medical because a few weeks ago my friend Liz alerted me to one of their products, the Bari-Suit. This is a "Training & Education" product that was awarded Most Interesting New Product at the Moving and Handling Conference 2012. Interesting it is.

It's a fat suit.

Marisa Meltzer's piece from 2006 framing fat suits as blackface still rings strongly, but I have written before that on some rare occasions fat suits can be eye-opening. Unfortunately the Bari-Suit has none of the nuance of a performance at Burger Queen, it is simply dehumanising and offensive, and presumably extremely expensive and profitable. There's no price on the website, you have to endure the Benmor Medical sales patter if you want to see how much it costs to rent or buy and when something is missing a price tag it usually means that it costs a fortune. It comes 'naked,' or dressed in Benmor Medical-branded sweats. It is so plainly ludicrous and vile that I wish I were making it up.

Medical teams could be employing actual fat people as part of their training into care for fat people in medical situations. This would entail having to talk to fat people with respect and care, finding out about fat people's lives, having to listen and create care paths that reflect direct accounts of what fat people need and want. This could be a great way of sharing knowledge between service providers and service users. The fat person gets paid for their expertise too!

Instead, they spend a lot of money on Benmor Medical's stupid, ugly fat suit. They get a normatively-sized person to try it on, they heave them about, they learn nothing at all about fat embodiment or identity in healthcare. In addition, using a fat suit in place of an actual person reinforces normatively-sized people's fantasies and stereotypes about what it is to be fat. This is particularly powerful because they do this as a group and the beliefs remain unquestioned because either there are no fat people in the room to counter them, or the fat people in the room are silenced by this ridiculous charade. This is what Benmor Medical regard as a good result, it's from the promotional download for their Bari-Suit from the company's website:

"Maryke Gosliga, Manual Handling Co-ordinator at Kettering General Hospital [...] commented: 'Having rented the suit for a bariatric study day this January, I have to say that it was a decision I am glad to have made. Seeing one of their colleagues wearing the suit made others really think about the issues, especially as it made the person wearing it less independent, because of the mechanics involved. Getting the trousers on was difficult, as was moving about. Those who did wear the suit learnt a lot that day! Altogether it was a good experience for all of us on our study day.'"

I can barely bring myself to comment on this patronising rubbish and I am struggling not to be sarcastic about how this team really thought about the issues, the mechanics, and the difficulty of getting those horrible trousers on and off. Good work, Kettering General!

The Bari-Suit truly exemplifies the profound inability of medical professionals to see fat people as human or real in a context where this must surely be the baseline from which care is given. Instead, a nasty little outfit is seen as an adequate substitution for years of experience, complex relationships to embodiment, engagement with social exclusion, or the possibilities that fat people have community and culture and agency of far more depth than medical discourse can currently encompass. Benmor Medical are not the originators of this state of affairs, the rot is much more pervasive, it's a part of the culture from which they profit.

I want to add a brief coda. At the end of June I had the great good fortune to attend the Allied Media Conference in Detroit. This is a really fantastic event combining grassroots activism with DIY media technology, defined in the broadest of ways. Many different types of people attend. Look at the session lists and comments and archived videoed sessions to get a feel for the conference, save up and attend next year if you can, I can't recommend it highly enough and would love to return.

The conference has been going for some years and each year there are particular session threads devoted to certain areas of interest. This year Research Justice was one such theme. This refers to the practice of developing accountable, participatory and liberatory research methodologies, especially when directed towards marginalised people. These values should be at the heart of all research, of course, but this is not always the case, especially in terms of obesity research, where fat people are routinely made abject and absent.

At one of the Research Justice sessions, speakers talked about establishing and using community ethics boards as a means of making sure that research on those communities is accountable and inclusive. I thought this was an excellent and powerful idea. Imagine if every piece of obesity research had to pass a fat community ethics board in order to get funded or published, or to have any credibility in research communities. Imagine how that could help transform the current dismal situation for critical research into fat, and how that could alter the landscape for our encounters with medical science. It would mean no more Bari-Suits for sure.

Incidentally, I am intrigued by the popularisation of the term 'bariatric' and its diminutives. Are there any etymologists in the house who can illuminate its source and growth? It's one of those professional-expert-medic words that sounds so neutral but masks a world of problematic assumptions.

Meltzer, M. (2006) 'Are Fat Suits the New Blackface? Hollywood’s Big New Minstrel Show' in Jervis, L. and Zeisler, A., eds., Bitchfest: Ten Years of Cultural Criticism from the Pages of Bitch Magazine, New York: Farrar, Straus and Giroux, 267-269.

While I'm completely on board with your main points and have innumerable examples of how revolting the medical profession can be to fat people and the bari-suit thing is just a load of incredible WTF, I just have to nitpick about your point about scales. Being able to weigh all patients in healthcare is important. There are a number of drugs used, particularly in critical care and surgical settings for which doses are calculated on milligrams/kilogram. If you don't have an accurate weight recorded, you can't get the right dose of the drug. I think it was much worse when the equipment to weigh all patients wasn't available & fat people just got a 'whatever' dose based on a guess. And from my perspective as a fat person, I'd feel a lot more stigmatised if I went to have surgery and there were no scales capable of weighing me (a standard part of pre-op preparation).